Whenever there are interesting articles published which could affect the vision of my patients, I like to let you know.  The following abstract is from The Journal of the American Medical Association.  The article describes increased risks for complications during cataract surgery if you, or your loved one, is taking  tamsulosin (Flomax)for the treatment of benign prostatic hypertrophy(BPH).  If you have taken Flomax in the past, or are taking it now, please make sure to tell your eye surgeon before cataract surgery so that special measures can be taken to minimize the risks of vision loss.  Cataract surgery is safe, but letting your cataract surgeon know beforehand will make it even safer.

Association Between Tamsulosin (Flomax) and Serious Ophthalmic Adverse Events in Older Men Following Cataract Surgery.

 Chaim M. Bell, MD, PhD; Wendy V. Hatch, OD, MSc; Hadas D. Fischer, MD; Geta Cernat, MD, MSc; J. Michael Paterson, MSc; Andrea Gruneir, PhD; Sudeep S. Gill, MD, MSc; Susan E. Bronskill, PhD; Geoffrey M. Anderson, MD, PhD; Paula A. Rochon, MD, MPH

JAMA. 2009;301(19):1991-1996.

Context    Both benign prostatic hyperplasia (BPH) and cataract formation are common in older men. The  -adrenergic receptor blocker tamsulosin is frequently prescribed to treat BPH, and research suggests this drug may increase the intraoperative difficulty of cataract surgery. No studies have documented whether use of tamsulosin or other  -blocker drug therapies affect the risk of serious postoperative adverse events.

Objective    To assess the risk of adverse events following cataract surgery in older men prescribed tamsulosin or other  -blocking drugs used to treat BPH.

Design    Setting, and Patients  Nested case-control analysis of a population-based retrospective cohort study using linked health care databases from Ontario, Canada. We included all men aged 66 years or older who had cataract surgery between 2002 and 2007 (N = 96 128).

Main Outcome Measures     A composite of procedures signifying retinal detachment, lost lens or lens fragment, or endophthalmitis occurring within 14 days after cataract surgery. The risk of these adverse events was compared between men treated with tamsulosin or other  -blockers and men with no exposure to these medications in the year prior to cataract surgery. We separately examined the association of drug exposure that was either recent (within the 14 days before surgery) or previous (15-365 days before surgery).

Results    Overall, 3550 patients (3.7%) in the cohort had recent exposure to tamsulosin and 7426 patients (7.7%) had recent exposure to other  -blockers. Two hundred eighty-four patients (0.3%) had an adverse event. We randomly matched 280 of the cases to 1102 controls according to their age, surgeon, and year of surgery. Adverse events were significantly more common among patients with recent tamsulosin exposure (7.5% vs 2.7%; adjusted odds ratio [OR], 2.33; 95% confidence interval [CI], 1.22-4.43) but were not associated with recent exposure to other  -blockers (7.5% vs 8.0%; adjusted OR, 0.91; 95% CI, 0.54-1.54) or to previous exposure to either tamsulosin ( 1.8% vs 1%; adjusted OR, 0.94; 95% CI, 0.27-3.34) or other  -blockers (2.9% vs 2.1%; adjusted OR, 1.08; 95% CI, 0.47-2.48). This corresponds to an estimated number needed to harm (NNH) of 255 (95% CI, 99-1666).

Conclusions  Exposure to tamsulosin within 14 days of cataract surgery was significantly associated with serious postoperative ophthalmic adverse events. There were no significant associations with exposure to other  -blocker medications used to treat BPH.

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